盐酸法舒地尔治疗急性脑梗死临床观察
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摘要
目的分析盐酸法舒地尔治疗急性脑梗死的疗效及对血管内皮生长因子的影响。方法选取信阳市中心医院2013-02—2016-08收治的120例急性脑梗死患者,随机分为实验组与对照组,每组60例。对照组应用尼莫地平+阿司匹林治疗,实验组应用盐酸法舒地尔+阿司匹林治疗。分析2组总有效率、治疗前后神经功能缺损评分、血清CRP、肿瘤坏死因子、白细胞介素6(IL-6)、白细胞介素4(IL-4)以及对血管内皮生长因子(VEGF)的影响等参数指标。结果 (1)实验组总有效率95.00%(57/60),对照组为87.67%(46/60),实验组总有效率高于对照组(P<0.05);(2)治疗前2组神经功能缺损评分比较差异无统计学意义(P>0.05);治疗后,实验组神经功能缺损评分显著低于对照组(P<0.05);(3)治疗前2组血清CRP、肿瘤坏死因子、IL-6、IL-4以及VEGF水平比较差异无统计学意义(P>0.05);治疗后,实验组血清CRP、肿瘤坏死因子、IL-6、IL-4以及血管内皮生长因子(VEGF)表达水平显著低于对照组,差异有统计学意义(P<0.05)。结论盐酸法舒地尔有效减少急性脑梗死患者血清CRP、肿瘤坏死因子、IL-6、IL-4以及VEGF水平,提高临床疗效。
Objective To analyze the application of fasudil hydrochloride in patients with acute cerebral infarction and its effect on vascular endothelial growth factor.Methods From February 2013 to August 2016,120 patients with acute cerebral infarction admitted to Xinyang Central Hospital were selected as the study subjects.They were randomly divided into experimental group and control group according to the order of admission,with 60 cases in each group.The control group was treated with nimodipine + aspirin,and the experimental group was treated with fasudil hydrochloride + aspirin.Statistical analysis was performed using SPSS 20.0 statistical software.The total effective rate of clinical treatment,neurological deficit score before and after treatment,serum high-sensitivity C-reactive protein,tumor necrosis factor,interleukin-6,interleukin-4 and Parameters such as the influence of vascular endothelial growth factor(VEGF).Results The total effective rate of clinical treatment in the experimental group was 95.00%(57/60),and the total effective rate in the control group was 87.67%(46/60).The total effective rate of clinical treatment in the experimental group was much higher than that in the control group(P<0.05).Before treatment,there was no significant difference in neurological deficit score between the experimental group and the control group(P>0.05).After treatment,the neurological deficit score of the experimental group was significantly lower than that of the control group.Group(P<0.05).There was no significant difference in serum high-sensitivity C-reactive protein,tumor necrosis factor,interleukin-6,interleukin-4 and vascular endothelial growth factor(VEGF) levels between the two groups before treatment.Significance(P>0.05);after treatment,the serum levels of high-sensitivity C-reactive protein,tumor necrosis factor,interleukin-6,interleukin-4 and vascular endothelial growth factor(VEGF) in the experimental group were significantly lower than those in the control group.Statistical significance(P<0.05).Conclusion Fasudil hydrochloride can effectively reduce the levels of serum CRP,tumor necrosis factor,IL-6,IL-4 and VEGF in patients with acute cerebral infarction,and improve the total effective rate of treatment.
Objective To analyze the application of fasudil hydrochloride in patients with acute cerebral infarction and its effect on vascular endothelial growth factor.Methods From February 2013 to August 2016,120 patients with acute cerebral infarction admitted to Xinyang Central Hospital were selected as the study subjects.They were randomly divided into experimental group and control group according to the order of admission,with 60 cases in each group.The control group was treated with nimodipine + aspirin,and the experimental group was treated with fasudil hydrochloride + aspirin.Statistical analysis was performed using SPSS 20.0 statistical software.The total effective rate of clinical treatment,neurological deficit score before and after treatment,serum high-sensitivity C-reactive protein,tumor necrosis factor,interleukin-6,interleukin-4 and Parameters such as the influence of vascular endothelial growth factor(VEGF).Results The total effective rate of clinical treatment in the experimental group was 95.00%(57/60),and the total effective rate in the control group was 87.67%(46/60).The total effective rate of clinical treatment in the experimental group was much higher than that in the control group(P<0.05).Before treatment,there was no significant difference in neurological deficit score between the experimental group and the control group(P>0.05).After treatment,the neurological deficit score of the experimental group was significantly lower than that of the control group.Group(P<0.05).There was no significant difference in serum high-sensitivity C-reactive protein,tumor necrosis factor,interleukin-6,interleukin-4 and vascular endothelial growth factor(VEGF) levels between the two groups before treatment.Significance(P>0.05);after treatment,the serum levels of high-sensitivity C-reactive protein,tumor necrosis factor,interleukin-6,interleukin-4 and vascular endothelial growth factor(VEGF) in the experimental group were significantly lower than those in the control group.Statistical significance(P<0.05).Conclusion Fasudil hydrochloride can effectively reduce the levels of serum CRP,tumor necrosis factor,IL-6,IL-4 and VEGF in patients with acute cerebral infarction,and improve the total effective rate of treatment.
引文
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[2] 梁秀云,李通.盐酸法舒地尔对急性脑梗死患者血清Rho激酶的影响及与血液流变学相关性[J].现代中西医结合杂志,2012,21(4):348-349;370.
[3] 于爽,苏敏,樊泽新,王荔.急性脑梗死患者血清sTWEAK水平与颈动脉硬化的相关性研究[J].中国实用神经疾病杂志,2018,21(15):1 651-1 656.
[4] 谭文澜,张永全,陆晖,覃辉,莫国焕.血栓通治疗急性脑梗死的疗效及其对患者血清炎症因子水平的影响[J].广西医科大学学报,2018,35(11):1 513-1 516.
[5] 刘莉,张军.急性脑梗死患者血清hs-CRP,TNF-α和TIMP-1水平检测在疾病预后评估中的应用价值[J].现代检验医学杂志,2018,33(5):87-90;94.
[6] ISHIHARA M,YAMANAKA K,NAKAJIMA S,et al.Intracranial hemorrhage after intra-arterial administra-tion of fasudil for treatment of cerebral vasospasm following subarachnoid hemorrhage:A serious adverse event[J].Neuroradiology,2012,54(1):73-75.
[7] 卢婷,易琼.法舒地尔对急性脑梗死静脉溶栓后再灌注损伤的保护作用[J].医学临床研究,2017,34(12):2 378-2 380.
[8] 白焕芳.颈动脉粥样硬化斑块与急性脑梗死患者血清炎症因子水平关系的研究[J].河南医学研究,2018,27(22):4 078-4 080.
[9] 戴嘉青,胡学军.注射用依达拉奉联合纤溶酶对脑梗死患者D-二聚体、肿瘤坏死因子-α、c反应蛋白水平影响[J].临床军医杂志,2018,46(7):783-785.
[10] 李海军,高晓嵘,吴瑞,尚雪峰,张鹏轩,王玉娟.阿替普酶与巴曲酶治疗急性脑梗死的疗效比较及对患者血清NSE、IL-6、TNF-α、hs-CRP水平的影响[J].现代生物医学进展,2018,18(7):1 330-1 333.
[11] HOU Y,ZHOU L,YANG Q D,et al.Changes in hippocampal synapses and learning-memory abilities in a streptozotocin-treated rat model and intervention by using fasudil hydrochloride[J].Neuroscience,2012,200:120-129.
[12] 刘振宇,王丽华,周俊英,等.依达拉奉联合尤瑞克林治疗对急性脑梗死患者血液流变学及血管内皮细胞功能的影响[J].海南医学院学报,2014,20(3):337-339;343.
[13] 陈文军.苦碟子联合依达拉奉对急性脑梗死患者血清炎性因子及内皮素的影响[J].中国药业,2018,27(6):42-44.
[14] 贾二娟.血清Hcy、hs-CRP、IL-6和TNF-α水平与急性脑梗死严重程度的关系[J].实验与检验医学,2017,35(3):382-384.
[15] LI L,ZHI D,SHEN Y,et al.Effects of CC-chemokine receptor 5 on ROCK2 and P-MLC2 expression after focal cerebral ischaemia-reperfusion injury in rats[J].Brain Inj,2016,30(4):468-473.
[16] NUNES K P,RIGSBY C S,WEBB R C.RhoA/Rho-kinase and vascular diseases:what is the link?[J].Cell Mol Life Sci,2010,67(22):3 823-3 836.
[17] RAGHAVAN C T,NAGARAJ R H.AGE-RAGE interaction in the TGFβ2-mediated epithelial to mesenchymal transition of human lens epithelial cells [J].Glycoconj J,2016,33(4):631-643.
[18] RAGHAVAN C T,NAGARAJ R H.Erratum to:AGE-RAGE interaction in the TGFβ2-mediated epithelial to mesenchymal transition of human lens epithelial cells[J].Glycoconj J,2016,33(5):837-838.
[19] LU Y,LI H,JIAN W.The Rho/Rho-associated protein kinase inhibitor fasudil in the protection of endothelial cells against advanced glycation end products through the nuclear factor κB pathway[J].Exp Ther Med,2013,6(2):310-316.
[20] HUANG X,CHEN X,CHEN H,et al.Rho/Rho-associated protein kinase signaling pathway-mediated downregulation of runt-related transcription factor 2 expression promotes the differentiation of dental pulp stem cells into odontoblasts[J].Exp Ther Med,2018,15(5):4 457-4 464.
[21] 李慧.东菱迪芙联合依达拉奉对老年脑梗死患者血清血管内皮生长因子、同型半胱氨酸和肿瘤坏死因子α的影响[J].实用临床医药杂志,2017,21(1):22-24.
[22] 方晓霞,王云甫,张跃亮,等.依达拉奉联合法舒地尔应用于急性脑梗死患者的治疗效果观察[J].现代生物医学进展,2015,15(22):4 355-4 357;4 256.
[23] FUKUTA T,ASAI T,SATO A,et al.Neuroprotection against cerebral ischemia/reperfusion injury by intravenous administration of liposomal fasudil[J].Int J Pharm,2016,506(1/2):129-137.
[24] OJO O B,AMOO Z A,SALIU IO,et al.Neurotherapeutic potential of kolaviron on neurotransmitter dysregulation,excitotoxicity,mitochondrial electron transport chain dysfunction and redox imbalance in 2-VO brain ischemia/reperfusion injury[J].Biomed Pharmacother,2019,111:859-872.
[25] CHEN J,LI Q,DONG R,et al.The effect of the Ras homolog gene family (Rho),member A/Rho associated coiled-coil forming protein kinase pathway in atrial fibrosis of type 2 diabetes in rats[J].Exp Ther Med,2014,8(3):836-840.
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